Luster Jamie E, Turner Abigail Norris, Alkhalaileh Duna, Gallo Maria F
Division of Epidemiology, College of Public Health, The Ohio State University, 324 Cunz Hall, 1841 Neil Ave., Columbus, OH.
Division of Infectious Diseases, College of Medicine, The Ohio State University, N1144 Doan Hall, 410 W. 10th Ave., Columbus, OH.
Contraception. 2017 Jun;95(6):558-563. doi: 10.1016/j.contraception.2017.03.001. Epub 2017 Mar 8.
We aimed to describe contraceptive methods used by women in Malawi and determine whether contraceptive use differed by self-reported HIV status. Effective contraception is a primary method of preventing mother-to-child transmission of HIV.
Analysis is based on 12,658 nonpregnant, sexually debuted women ages 15-49 years in the 2010 Malawi Demographic and Health Survey. Analysis was restricted to respondents with contraceptive need (i.e., fecund and did not want a child in the next 12 months) who reported their last HIV test result. We accounted for the two-stage cluster sampling design by applying cluster, stratum and sample weights. We assessed differences in contraceptive method use by HIV status with χ tests and multivariable logistic regression.
A total of 893 (7.0%) of respondents reported being HIV positive. Use of long-acting reversible contraception (LARC) was low and did not differ between HIV-positive (1.4%) and HIV-negative (1.9%) women [adjusted odds ratio (aOR)=0.7, 95% confidence interval (CI), 0.4-1.4]. HIV-positive women (15.6%) were less likely than HIV-negative women (30.4%) to use progestin-only injectable contraception (aOR, 0.7; 95% CI, 0.5-0.8). Prevalence of female sterilization was higher among HIV-positive women (17.9%) compared to HIV-negative women (9.2%; aOR=1.7; 95% CI, 1.2-2.3).
LARC use was low among adult women with contraceptive need in Malawi. HIV-positive women were less likely to report progestin-only injectable use but more likely to report having undergone female sterilization compared to their HIV-negative counterparts. Noncoercive interventions that provide highly effective methods of contraception to HIV-positive women with contraceptive need are valuable methods of vertical transmission prevention in Malawi.
Contraceptive use differed by self-reported HIV status among adult women with contraceptive need in Malawi. Female sterilization was significantly higher, and use of progestin-only injectables was significantly lower, among HIV-positive women compared to their HIV-negative counterparts. Use of long-acting reversible contraception was low among both HIV-positive and HIV-negative women.
我们旨在描述马拉维女性使用的避孕方法，并确定避孕方法的使用是否因自我报告的艾滋病毒感染状况而异。有效的避孕是预防艾滋病毒母婴传播的主要方法。
分析基于2010年马拉维人口与健康调查中12,658名年龄在15 - 49岁、非怀孕且有过性行为的女性。分析仅限于有避孕需求（即有生育能力且在未来12个月内不想生育）并报告了其上次艾滋病毒检测结果的受访者。我们通过应用聚类、分层和样本权重来考虑两阶段整群抽样设计。我们使用χ检验和多变量逻辑回归评估了避孕方法使用在艾滋病毒感染状况方面的差异。
共有893名（7.0%）受访者报告艾滋病毒呈阳性。长效可逆避孕法（LARC）的使用率较低，艾滋病毒阳性女性（1.4%）和艾滋病毒阴性女性（1.9%）之间无差异[调整后的优势比（aOR）=0.7，95%置信区间（CI），0.4 - 1.4]。艾滋病毒阳性女性（15.6%）使用仅含孕激素的注射避孕法的可能性低于艾滋病毒阴性女性（30.4%）（aOR，0.7；95% CI，0.5 - 0.8）。与艾滋病毒阴性女性（9.2%）相比，艾滋病毒阳性女性的女性绝育率更高（17.9%；aOR = 1.7；95% CI，1.2 - 2.3）。
在马拉维有避孕需求的成年女性中，长效可逆避孕法的使用率较低。与艾滋病毒阴性女性相比，艾滋病毒阳性女性报告仅使用含孕激素注射避孕法的可能性较小，但接受女性绝育的可能性较大。为有避孕需求的艾滋病毒阳性女性提供高效避孕方法的非强制性干预措施是马拉维预防垂直传播的重要方法。
在马拉维有避孕需求的成年女性中，避孕方法的使用因自我报告的艾滋病毒感染状况而异。与艾滋病毒阴性女性相比，艾滋病毒阳性女性的女性绝育率显著更高，仅含孕激素注射避孕法的使用率显著更低。艾滋病毒阳性和阴性女性中长效可逆避孕法的使用率都较低。
